Now, a new study published earlier this month in the Journal of the American Medical Association, is making an even stronger case for the bariatric procedures and their impact on heart health. Researchers in a Swedish Obese Subjects study found that weight loss surgery clearly cut a patient’s risk of heart attack, stroke and fatal cardiovascular disease.

But the research also raises interesting questions about which factors, aside from weight loss, impact cardiovascular health, and which bariatric patients benefit the most from these kinds of procedures. For instance, patients with elevated insulin levels before surgery reaped the greatest rewards from the procedures, which suggests that insulin may be a better criteria for selecting patients than body mass index readings.

Ultimately, these t may be time for experts to reconsider the criteria for recommending bariatric surgery, he said.